SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC: Form 990, tax year 2012
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- Organization
- SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC (EIN 64-0625076)
- Tax period
- 2012-02-01 to 2013-01-31
- Filed
- 2013-05-22
- IRS object ID
- 201301429349300535
- Schema version
- 2012v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-22T13:48:41-07:00 | Timestamp |
| Tax Period End Date | 2013-01-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TERRY HORNE CPA & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 WEST MAIN STREET | AddressLine1 |
| City | LEBANON | City |
| State | TN | State |
| ZIP Code | 37087 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-02-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 640625076 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 6015458700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5488 US HWY 49/PO BOX 1729 | AddressLine1 |
| City | HATTIESBURG | City |
| State | MS | State |
| ZIP Code | 394031729 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GEROLDEAN DYSE | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 6015458700 | Phone |
| Date Signed | 2013-05-22 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERRY HORNE | Name |
| Phone | 6154447293 | Phone |
| Date Prepared | 2013-05-22 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GEROLDEAN DYSE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5488 US HWY 49 | AddressLine1 |
| City | HATTIESBURG | City |
| State | MS | State |
| ZIP Code | 39403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17258849 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1979 | YearFormation |
| State Legal Domicile | MS | StateLegalDomicile |
| Activity Or Mission Description | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 260 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 7099390 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7780469 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9178833 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9447201 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 39763 | InvestmentIncomePriorYear |
| Investment Income Current Year | 31179 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16317986 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17258849 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10401456 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11085716 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4840042 | OtherExpensePriorYear |
| Other Expenses Current Year | 5361432 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15241498 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16447148 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1076488 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 811701 | RevenuesLessExpensesCY |
| Total Assets BOY | 10811167 | TotalAssetsBOY |
| Total Assets EOY | 11255394 | TotalAssetsEOY |
| Total Liabilities BOY | 4370890 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4003416 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6440277 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7251978 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE ORGANIZATION PROVIDES HEALTH CARE | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 13154060 | Expense |
| Revenue | 9447201 | Revenue |
| Description | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 90,900 VISITS WERE PROVIDED DURING THE YEAR. | Description |
| Total Program Service Expense | 13154060 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 18 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 260 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MS | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | POLLY EUBANKS | NamePerson |
| Telephone Number | 6015458700 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5488 US HWY 49 | AddressLine1 |
| City | HATTIESBURG | City |
| State | MS | State |
| ZIP Code | 39403 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| KERMIT RAYBORN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| BILL FOLKES | |||||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 | ||
| KAREN SPEED | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOYCE WOULLARD | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| GINGER BURKS | |||||||
| VICE PRESIDENT | 1.00 | X | 0 | 0 | 0 | ||
| NANNI T FREEMAN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DESSIE WILLIAMS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| SHARENE CONERLY | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | ||
| HULDAH INGRAM | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| FRANKIE THOMAS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM RESTER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| GEROLDEAN DYSE | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | 120699 | 0 | 49017 | X | ||
| BRANDON COLEMAN | |||||||
| MEDICAL DIRECTOR (TERMINATED) | 40.00 | 110693 | 0 | 20515 | X | ||
| JAMES GRIFFIN | |||||||
| MEDICAL DIRECTOR | 40.00 | 180965 | 0 | 49893 | X | ||
| POLLY EUBANKS | |||||||
| CHIEF FINANCIAL OFFICER | 40 | 73599 | 46429 | X | |||
| NATHANIEL SONES | |||||||
| CHIEF INFORMATION OFFICER | 40 | 66606 | 43475 | X | |||
| JANICE ROBINSON | |||||||
| CHIEF HUMAN RESOURCE OFFICER | 40 | 64475 | 43247 | X | |||
| KEITH KERSTEN | |||||||
| PHYSICIAN | 40 | 195681 | 54835 | X | |||
| HOSSEIN BEHNIAYE | |||||||
| PHYSICIAN | 40 | 158583 | 56952 | X | |||
| HASSAN BEHNIAY | |||||||
| PHYSICIAN | 40 | 157307 | 55554 | X | |||
| QUENYATTA ECHOLS-WILLIAMS | |||||||
| PHYSICIAN | 40 | 153125 | 52342 | X | |||
| PATRICIA THOMPSON | |||||||
| CFNP | 40 | 120117 | 11509 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1401850 | TotalReportableCompFromOrg |
| Total Other Compensation | 483768 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| LABCORP OF AMERICA | |||||
| 231 MAPLE AVENUE | BURLINGTON | NC | 27215 | LAB SERVICES | 364497 |
| ALLSCRIPTS | |||||
| 24630 NETWORK PLACE | CHICAGO | IL | 606731246 | COMPUTER SERVICES | 210357 |
| FOREST GENERAL HOSPITAL | |||||
| PO BOX 16389 | HATTIESBURG | MS | 39404 | CONTRACT PHYSICIAN | 148025 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Government Grants | 6420550 | GovernmentGrants |
| All Other Contributions | 1359919 | AllOtherContributions |
| Noncash Contributions | 501145 | NoncashContributions |
| Total Contributions | 7780469 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT FEES | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 9447201 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9447201 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31179 | TotalRevenueColumn |
| Exclusion | $31,179 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17258849 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9447201 | RelatedOrExemptFunctionIncome |
| Exclusion | $31,179 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 617037 | Total |
| Program Services | 291658 | ProgramServices |
| Management And General | 325379 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8152558 | Total |
| Program Services | 7274079 | ProgramServices |
| Management And General | 878479 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 791725 | Total |
| Program Services | 688792 | ProgramServices |
| Management And General | 102933 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1005654 | Total |
| Program Services | 858714 | ProgramServices |
| Management And General | 146940 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 518742 | Total |
| Program Services | 451306 | ProgramServices |
| Management And General | 67436 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4088 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 4088 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32480 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 32480 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1159300 | Total |
| Program Services | 801683 | ProgramServices |
| Management And General | 357617 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2522506 | Total |
| Program Services | 1766614 | ProgramServices |
| Management And General | 755892 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 745804 | Total |
| Program Services | 450768 | ProgramServices |
| Management And General | 295036 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286711 | Total |
| Program Services | 97031 | ProgramServices |
| Management And General | 189680 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 597184 | Total |
| Program Services | 461392 | ProgramServices |
| Management And General | 135792 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13359 | Total |
| Program Services | 12023 | ProgramServices |
| Management And General | 1336 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16447148 | Total |
| Program Services | 13154060 | ProgramServices |
| Management And General | 3293088 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1731783 | BOY |
| EOY | 2764652 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4439 | BOY |
| EOY | 4993 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 921355 | BOY |
| EOY | 726103 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 427617 | BOY |
| EOY | 478642 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78262 | BOY |
| EOY | 75197 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10993872 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4909155 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6555980 | BOY |
| EOY | 6084717 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1091731 | BOY |
| EOY | 1121090 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10811167 | BOY |
| EOY | 11255394 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1179917 | BOY |
| EOY | 1289510 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3190973 | BOY |
| EOY | 2713906 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4370890 | BOY |
| EOY | 4003416 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6258252 | BOY |
| EOY | 7043656 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 182025 | BOY |
| EOY | 208322 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6440277 | BOY |
| EOY | 7251978 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10811167 | BOY |
| EOY | 11255394 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 811701 | ReconcilationRevenueExpenses |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5611133 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6324528 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7178218 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7099390 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7780469 | CurrentTaxYear |
| Total | 33993738 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5611133 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6324528 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7178218 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7099390 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7780469 | CurrentTaxYear |
| Total | 33993738 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 33993738 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 44779 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 45373 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 55845 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 39763 | CurrentTaxYearMinus1Year |
| Current Tax Year | 31179 | CurrentTaxYear |
| Total | 216939 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 34210677 | TotalSupport |
| Gross Receipts From Admissions Etc | 44113092 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99370 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99270 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| Public Support Total509 | 0 | PublicSupportTotal509 |
| Public Support Percentage509 | 0 | PublicSupportPercentage509 |
| Investment Income Percentage | 0 | InvestmentIncomePercentage |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 260525 | InvestmentCostOrOtherBasis |
| Book Value | 260525 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 8783867 | InvestmentCostOrOtherBasis |
| Depreciation | 3398605 | Depreciation |
| Book Value | 5385262 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1949480 | InvestmentCostOrOtherBasis |
| Depreciation | 1510550 | Depreciation |
| Book Value | 438930 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6084717 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENT | 1113362 |
| DEPOSITS | 7728 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1121090 | TotalBookValueOtherAssets |
| Tot Revenue Etc Audited Fincl Stmt | 17258849 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 17258849 | RevenueSubtotal |
| Total Revenue Per Form990 | 17258849 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 16447148 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 16447148 | ExpensesSubtotal |
| Total Expenses Per Form990 | 16447148 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|
| GEROLDEAN DYSE | |||
| 120699 | 39076 | 9941 | 169716 |
| JAMES GRIFFIN | |||
| 180965 | 44443 | 5450 | 230858 |
| KEITH KERSTEN | |||
| 195681 | 45242 | 9593 | 250516 |
| HOSSEIN BEHNIAYE | |||
| 158583 | 44246 | 12706 | 215535 |
| HASSAN BEHNIAY | |||
| 157307 | 42725 | 12830 | 212862 |
| QUENYATTA ECHOLS-WILLIAMS | |||
| 153125 | 43399 | 8942 | 205466 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 5522 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 276098 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | # OF CONTRIBUTIONS ARE EST @ FMV | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | DONATED PHARMACIST & 2 TECHS | Description |
| Number Of Contributions | 3 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 225047 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI, Line 12c | CONFLICT OF INTEREST IS MONITORED THROUGH VARIOUS COMPANIES SUCH AS: |
| ACCOUNTING POLICIES, EMPLOYMENT POLICIES AND COMPLIANCE POLICIES. WE CONSTANTLY | |
| MONITOR TO IDENTIFY CONFLICTS OF INTEREST AND ADDRESS THOSE | |
| ISSUES AS THEY RISE. | |
| Pt VI, Line 15a | SALARY SURVEYS SUCH AS NACHC's ANNUAL SALARY SURVEY, HORNE LLP SALARY SURVEY |
| Pt VI, Line 15b | AND OTHER FQHC's HAVE BEEN CONTACTED FOR COMPARABLE SALARY INFORMATION. |
| Pt VI, Line 11b | EACH BOARD MEMBER IS PROVIDED A COPY OF THE FINAL AUDIT REPORT AND THE REPORT |
| IS DISCUSSED DURING THE BOARD MEETING. THE CEO AND CFO PROVIDE THE | |
| INFORMATION FOR THE 990 TO BE COMPLETED AND REVIEW THE 990. | |
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST |
| POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. | |
| Pt XII, Line 2c | THE CEO AND CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT. |